Pulp canal obliteration (PCO) is a condition characterized by the pronounced deposition of hard tissue along the internal walls of the root canal that fills most of the pulp system leaving it narrowed and restricted. Teeth with PCO usually present with a yellowish or greyish discoloration. Different factors have been attributed to cause PCO. However, the exact pathogenesis of pulp obliteration still remains unclear. When the tooth is asymptomatic, the clinician is usually confronted with a dilemma of whether endodontic treatment should be initiated in such teeth or it should be delayed until clinical symptoms or radiographic signs of periapical disease develop. Endodontic treatment of teeth with PCO is often challenging. The possibility of iatrogenic errors during conventional approach using ultrasonics under dental operating microscope (DOM) are relatively high. Guided endodontics has recently gained popularity as a successful treatment option for PCO as it overcomes the drawbacks of the conventional approach. Additionally, the use of cone-beam computed tomography (CBCT) helps in the assessment of the extent and degree of obliteration three dimensionally and also aids in early identification of periapical lesion.